Feasibility of ultrasound-guided vascular access during cardiac implantable device placement

• Published in: Journal of interventional cardiac electrophysiology 2017-10, Vol.50 (1), p.105-109
• Main Authors: Lin, Jeffrey, Adsit, Graham, Barnett, Anne, Tattersall, Matthew, Field, Michael E., Wright, Jennifer
• Format: Article
• Language: English
• Subjects: Aged; Aged, 80 and over; Cardiology; Catheterization, Central Venous - methods; Catheters; Complications; Defibrillators, Implantable - utilization; Electronic devices; Electronic equipment; Feasibility Studies; Female; Fluoroscopy; Follow-Up Studies; Heart; Heart diseases; Hematoma; Humans; Implantation; Male; Medical instruments; Medicine; Medicine & Public Health; Middle Aged; Pacemaker, Artificial - utilization; Patient Safety; Placement; Pneumothorax; Prosthesis Implantation; Reference Values; Retrospective Studies; Thromboembolism; Thrombosis; Ultrasonography, Interventional - methods; Ultrasound; Vascular Access Devices; Venous access
• ISSN: 1383-875X; 1572-8595
• DOI: 10.1007/s10840-017-0273-3

Purpose Ultrasound (US)-guided access for venous catheter placement has previously been shown to improve success rates and decrease access-related complications. The purpose of this study was to determine the feasibility of US-guided versus traditional vascular access approaches during implantation of cardiac implantable electronic devices (CIEDs). Methods We evaluated outcomes for 816 consecutive patients undergoing new CIED implantation between May 2013 and April 2016 at a single institution with respect to use of US guidance for vascular access (137 with US guidance versus 679 with traditional access techniques). The primary outcome was a composite of procedural complications including deep vein thrombosis, pneumothorax, or hematoma. Results There was no cross-over between US guidance and traditional access. The overall complication rate was 3.6% (2.2% in US, 3.8% in non-US). The use of US was associated with a decrease in fluoroscopy time ( r  = −0.17, p